Francesco/who-killed-jfk huggingface dataset:
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# Office Memorandum • UNITED STATES GOVERNMENTTO: Chief, WH-4, SecurityFROM: Chief, Personnel Security Division, 08DATE: 17 November 1960SUBJECT: LYNCH, Grayston le Roy - #1891841. Subject is approved for appointment as specified in your request under provisions of CIA Regulations 20-1000 with access to information classified through TOP SECRET as required in performance of his duties, contingent upon a satisfactory polygraph interview.2. Arrangements for the polygraph interview are to be made by your office, however, contracting with the Subject should be delayed until you are advised by memorandum of the results.FOR THE DIRECTOR OF SECURITY:![signature of W.A. Coborne]W. A. CoborneSECRET
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# SECRETCONTRACT EMPLOYEE BIOGRAPHIC PROFILEName (True): Grayston L. LynchDate of Birth: 14 June 1923Place of Birth (City & State): Gilmer, TexasMarital Status: MarriedName of Spouse: Janette K. LynchNo. of Dependents (Excluding mployer) 3Years of Birth: 26 July 22/wife 11 Jan 54/son 4 Apr 19/sonClerical Skills: Typing Speed NA w.p.m.Shorthand Speed NA w.p.m.Non-KUBARK Employment:| Name of Firm | From (Mo-Yr) | To (Mo-Yr) | Position Title || ------------ | ------------ | ---------- | -------------- || U. S. Army   | Oct 1938     | Oct 1960   | Captain        || 2.           |              |            |                || 3.           |              |            |                || 4.           |              |            |                || 5.           |              |            |                || 6.           |              |            |                |Non-KUBARK Education| Name        | City & State  | Diploma/ Degree    | Year Completed | Major Fields || ----------- | ------------- | ------------------ | -------------- | ------------ || Pettus High | Pettus, Texas | Not Grad/Grad      | USAFI-1946     |              || College     |               | 1 yr college level | -USAFI         |              || Other       |               |                    |                |              |Foreign Languages & Proficiency:(Native, Good, Poor. None)| Language   | Read | Speak | Write | Understand || ---------- | ---- | ----- | ----- | ---------- || 1. Lao     |      | %     |       | Poor       || 2. Spanish | X    | X     |       | Poor       |KUBARK Sponsored Training:| Course Title | Year | Course Title | Year || ------------ | ---- | ------------ | ---- || 1. Radop     | 1961 |              |      || 2.           |      |              |      || 3.           |      |              |      |KUBARK Employment history:| From (Mo-Yr) | To (Mo-Yr) | Position Title | Equiv. GS Grade | F/T or P/T | Component & Location || ------------ | ---------- | -------------- | --------------- | ---------- | -------------------- || Feb 61       | June 61    | PM/ C/O        | GS-11           | F/T        | WII                  || June 61      | Present    | PM/ C/O        | GS-13           | F/T        | WII                  |
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Data as of 18 August 1965HAVE YOU EVER HAD ACTIVE MILITARY, MILITARY RESERVE,OR NATIONAL GUARD STATUS? YES NOIF YOU ANSWERED "NO" TO THE ABOVE QUESTION, SIGNTHIS FORM IN PSEUDOSYM AND RETURN IT TO THE PERSONNELBRANCH.IF YOU ANSWERED "YES" TO THE ABOVE QUESTION, COMPLETETHIS FORM AND RETURN IT TO THE PERSONNEL BRANCHPSEUDONYM DATE OF BIRTH(Please Print) LAST FIRST MI MO DAY YR## MILITARY SERVICE1. ARE YOU REGISTERED FOR THE DRAFT UNDER 1. CURRENT DRAFT STATUS   THE UNIVERSAL MILITARY TRAINING AND YES 2. SELECTIVE SERVICE CLASSIFY 3. SELECTIVE SERVICE NO.   SERVICE ACT OF 1948 (As amended) NO4. IF DEFERRED, GIVE REASON 5. LOCAL DRAFT BOARD NO. OR DESIGNATION AND ADDRESS2. MILITARY SERVICE RECORDCHECK (X) AS 1. CURRENT AND/OR PAST ORGANIZATIONAL MEMBERSHIPAPPROPRIATEARMY NAVY MARINE AIR COAST MERCHANT NATIONAL AIR NAT'L FOREIGN ORGAN. ON MIL.CORPS FORCE GUARD MARINE GUARD GUARD SERVICE (Specific)HAVE SERVED X2. BRANCH OR CORPS OF ABOVE CHECKED ORGANIZATION(S)3. DATE SEPARATED FROM EXTENDED ACTIVE DUTY (Past service) 4. TOTAL LENGTH OF EXTENDED ACTIVE DUTY IN U.S. ARMED FORCES310519605. DATE ENTERED PAST SERVICE 6. TOTAL LENGTH OF ACTIVE DUTY IN FOREIGN MILITARY, OR-   ACTIVE DUTY ORGANIZATION   OCT 14 19597. RANK, GRADE OR PAST SERVICE 8. SERVICE, SERIAL OR FILE NUMBER   RATE9. PRIMARY MILITARY OCCUPATIONAL PAST SERVICE   SPECIALTY (Mos of Designator) AND TITLE10. SECONDARY MIL. OCCUPATIONAL PAST SERVICE    SPECIALTY (Mos or Designator) AND    TITLE11. BRIEF DESCRIPTION OF MILITARY Experience:12. CHECK (X) TYPE OF SEPARATION FROM ACTIVE DUTY    HONORABLE DISCHARGE RETIREMENT FOR SERVICE UNIQUE HARDSHIPS    RELEASE TO INACTIVE DUTY RETIREMENT FOR COMBAT DISABILITY OTHER:    RETIREMENT FOR AGE RETIREMENT FOR PHYSICAL DISABILITY13. CHECK (X) COMPONENT IN WHICH YOU SERVED    REGULAR RESERVE (Including the National and Air National Guard) OTHER (Including AUS)## Military Reserve, National Guard Status1. DO YOU NOW HAVE 2. ARE YOU NOW A MEMBER OF THE YES 3. Are you a member   RESERVE STATUS? YES NAT'L. GRD. OR AIR NAT'L. NO of a FUBARK Reserve YES   NO GRD. Unit NO4. IF YOU HAVE ANSWERED "YES" TO ITEMS 1, 2 OR 3 ABOVE, CHECK COMPONENT MEMBERSHIP BELOWARMY MARINE CORPS NATIONAL GUARD COAST GUARD NAVY ROTCAIR FORCE AIR NAT'L. GUARD KUBARK Category: I II III5. CURRENT RANK, GRADE OR 6. DATE OF APPOINTMENT IN CURRENT 7. EXPIRATION DATE OF CURRENT RESERVE OBLIGA-   RATE RANK TION8. CURRENT RESERVE CATEGORY: READY RESERVE STANDBY(Active) STANDBY(Inactive) RETIRED9. PRIMARY MILITARY OCCUPATIONAL SPECIALTY (Mos of Des- 10. SECONDARY MILITARY OCCUPATIONAL SPECIALTY (Mos of Des- ignator) AND TITLE ignator) AND TITLE11. BRIEF DESCRIPTION OF MILITARY RESERVE DUTIES15. IF YOU HAVE ANSWERED "YES" TO ITEM 12, GIVE UNIT OR AGENCY    AND ADDRESS16. IF YOU HAVE ANSWERED "YES" TO ITEM 15, GIVE UNIT OR AGENCY    AND ADDRESS17. WHAT ARE YOUR SERVICE RECORDS IDENTIPresent Marital Status: Single MarriedSECRETSIGNATURE (P)
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# PERSONAL HISTORY STATEMENTINSTRUCTIONS1. Answer all questions completely or check appropriate box. If question is not applicable, write "NA". Write "Unknown" only if you do not know the answer and it cannot be obtained from personal records. Use blank space at end of form for extra details on any question for which you have insufficient space.2. Type, print or write carefully; illegible or incomplete forms will not receive consideration.3. Consider your answers carefully. Your signature at the end of this form will certify to their correctness. Careful completion of all applicable questions will permit review of your qualifications to the best advantage.SECTION IGENERAL PERSONAL AND PHYSICAL DATA1. FULL NAME (Last-First-Middle)2. AGE373. SEX4. HEIGHT5. WEIGHT6. COLOR OF EYES7. COLOR OF HAIR8. TYPE COMPLEXION9. TYPE BUILD10. SCARS (Type and Location)11. OTHER DISTINGUISHING PHYSICAL FEATURES12. CURRENT ADDRESS (No., Street, City, Zone, State and Country)13. PERMANENT ADDRESS (No. Street, City, Zone, State and Country) AND PHONE NO.14. CURRENT PHONE NO.15. OFFICE PHONE NO. & EXT.16. LEGAL RESIDENCE (State, Territory of Country)17. NICKNAMES18. OTHER NAMES YOU HAVE USED19. INDICATE CIRCUMSTANCES (Including Length of Time) UNDER WHICH YOU HAVE EVER USED THESE NAMES.20. IF LEGAL CHANGE, GIVE PARTICULARS (Where and by What Authority).SECTION IIPOSITION DATA1. INDICATE THE TYPE OF WORK OR POSITION FOR WHICH YOU ARE APPLYING2. INDICATE THE LOWEST ANNUAL ENTRANCE SALARY YOU WILL ACCEPT (You will not be considered for any position with a lower entrance salary).$3. DATE AVAILABLE FOR EMPLOYMENT4. INDICATE YOUR WILLINGNESS TO TRAVELOCCASIONALLYFREQUENTLYCONSTANTLYOTHER5. INDICATE YOUR WILLINGNESS TO ACCEPT ASSIGNMENT IN THE FOLLOWING LOCATIONS (Check (X) each item applicable)WASHINGTON, D.C.ANYWHERE IN U.S.CERTAIN LOCATIONS ONLY (Specify):OUTSIDE CONTINENTAL U.S.6. INDICATE WHAT RESERVATIONS YOU WOULD PLACE ON ASSIGNMENTS OUTSIDE THE WASHINGTON, D.C. AREA.
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# PERSONAL HISTORY STATEMENTINSTRUCTIONS1. Answer all questions completely or check appropriate box. If question is not applicable, write "NA". Write "Un- known" only if you do not know the answer and it cannot be obtained from personal records. Use blank space at end of form for extra details on any question for which you have insufficient space.2. Type, print or write carefully; illegible or incomplete forms will not receive consideration.3. Consider your answers carefully. Your signature at the end of this form will certify to their correctness. Careful completion of all applicable questions will permit review of your qualifications to the bent advantage.SECTION I GENERAL PERSONAL AND PHYSICAL DATA1. FULL NAME (Last-First-Middle)2. AGE3. SEXMALEFEMALE4. HEIGHT5. WEIGHT6. COLOR OF EYES7. COLOR OF HAIR8. TYPE COMPLEXION9. TYPE BUILD10. SCARS (Type and location)11. OTHER DISTINGUSHING PHYSICAL FEATURES12. CURRENT ADDRESS (No., Street, City, Zone, State and Country)13. PERMANENT ADDRESS (No., Street, City, Zone, State and Country) AND PHONE NO.14. CURRENT PHONE NO.15. OFFICE PHONE NO. & EXT.16. LEGAL RESIDENCE (State, Territory of Country)17. NICKNAMES18. OTHER NAMES YOU HAVE USED19. INDICATE CIRCUMSTANCES (Including Length of Time) UNDER WHICH YOU HAVE EVER USED THESE NAMES.20. IF LEGAL CHANGE, GIVE PARTICULARS (Where and by What Authority).SECTION 11 POSITION DATA1. INDICATE THE TYPE OF WORK OR POSITION FOR WHICH YOU ARE APPLYING2. INDICATE THE LOWEST ANNUAL ENTRANCE SALARY YOU WILL ACCEPT (You will not be considered for any position with a lower entrance salary).3. DATE AVAILABLE FOR EMPLOYMENT4. INDICATE YOUR WILLINGNESS TO TRAVELOCCASIONALLYFREQUENTLYCONSTANTLYOTHER5. INDICATE YOUR WILLINGNESS TO ACCEPT ASSIGNMENT IN THE FOLLOWING LOCATIONS (Check (X) each item applicable)WASHINGTON. D.C.ANYWHERE IN U.S.CERTAIN LOCATIONS ONLY (Specify):OUTSIDE CONTINENTAL U.S.6. INDICATE WHAT RESERVATIONS YOU WOULD PLACE ON ASSIGNMENTS OUTSIDE THE WASHINGTON. D.C. AREA.
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### SECTION IIICITIZENSHIP1. DATE OF BIRTH2. PLACE OF BIRTH (City, State, Country)3. PRESENT CITIZENSHIP (Country)4. CITIZENSHIP ACQUIRED BYMARRIAGE  OTHER (Specify):5. DATE NATURALIZED6. NATURALIZATION CERTIFICATE NO.7. COURT ISSUING NATURALIZATION CERTIFICATE8. ISSUED AT (City, State, Country)9. HAVE YOU HELD PREVIOUS NATIONALITY 10. IF YES, GIVE NAME OF COUNTRYYES NO11. GIVE PARTICULARS CONCERNING PREVIOUS NATIONALITY.12. HAVE YOU TAKEN STEPS TO CHANGE PRESENT CITIZENSHIPYES NO13. GIVE PARTICULARS14. IF YOU HAVE APPLIED FOR U.S. CITIZENSHIP, WHAT IS PRESENT STATUS OF YOUR APPLICATION (First Papers, Etc.)?15. DATE OF ARRIVAL IN U.S.16. PORT OF ENTRY17. ON PASSPORT OF WHAT COUNTRY18. LAST U.S. VISA (No. Type, Place of Issue)19. DATE VISA ISSUED### SECTION IVEDUCATION1. CHECK (X) HIGHEST LEVEL OF EDUCATION ATTAINED.LESS THAN HIGH SCHOOL GRADUATE OVER TWO YEARS OF COLLEGE, NO DEGREEHIGH SCHOOL GRADUATE BACHELOR'S DEGREETRADE, BUSINESS. OR COMMERCIAL SCHOOL GRADUATE GRADUATE STUDY LEADING TO HIGHER DEGREETWO YEARS COLLEGE OR LESS MASTER'S DEGREE DOCTOR'S DEGREE2. ELEMENTARY SCHOOL1. NAME OF ELEMENTARY SCHOOL 2. ADDRESS (City, State, Country)3. DATES ATTENDED (From-and-To) 4. GRADUATEYES NO3. HIGH SCHOOL1. NAME OF HIGH SCHOOLUSA FT 2. ADDRESS (City, State, Country)3. DATES ATTENDED (From-and-To) 4. GRADUATEYES NO1. NAME OF HIGH SCHOOL 2. ADDRESS (City, State, Country)3. DATES ATTENDED (From-and-To) 4. GRADUATEYES NO4. COLLEGE OR UNIVERSITY STUDY| NAME AND LOCATION OF COLLEGE OR UNIVERSITY | SUBJECT MAJOR/MINOR | DATES ATTENDED FROM TO | DEGREE REC'D | DATE REC'D | SEM/QTR HOURS (Specify) || ------------------------------------------ | :-----------------: | :--------------------: | :----------: | :--------: | :---------------------: || USA FT                                     |                     |       1967 1969        |      BA      |            |                         |SECTION IV CONTINUED TO PAGE 1
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SECTION VI GEOGRAPHIC AREA KNOWI EDGE AND FOREIGN TRAVEL1.  LIST DELOW ANY FOREIGN REGIONS OR COUNTRIES IN WHICH YOU HAVE TRAVELLED OR GAINED KNOWLEDGE AS A RESULT OF    RESIDENCE, STUDY OR WORK ASSIGNMENT. INDICATE TYPE OF KNOWLEDGE SUCH AS TERRAIN, HARBORS, UTILITIES, RAIL    ROADS, INDUSTRIES, POLITICAL PARTIES, ETC.| NAME OF REGION OR COUNTRY | TYPE OF SPECIALIZED KNOWLEDGE | DATES OF RESIDENCE OR TRAVEL | DATES AND PLACE OP STUDY | KNOWLEDGE ACQUIRED AY RESIDENCE | TRAVEL | STUDY | WORK ASSIGNMENT || ------------------------- | ----------------------------- | ---------------------------- | ------------------------ | ------------------------------- | ------ | ----- | --------------- ||                           |                               |                              |                          |                                 |        |       |                 ||                           |                               |                              |                          |                                 |        |       |                 ||                           |                               |                              |                          |                                 |        |       |                 ||                           |                               |                              |                          |                                 |        |       |                 |2. INDICATE THE PURPOSE OF VISIT, RESIDENCE, OR TRAVEL IN EACH OF THE REGIONS OR COUNTRIES LISTED ABOVE.3. UNITED STATES PASSPORT NUMBER AND EXPIRATION DATE. IF ISSUED.SECTION VII TYPING AND STENOGRAPHIC SKILLS1.  TYΡΙΝΟwpm 2. SHORTHAND (Win)|                          | GREGG | SPEEDWRITING | STENOTYPE | OTHER (Specity): || ------------------------ | ----- | ------------ | --------- | ---------------- || 3. SHORTHAND SYSTEM USED |       |              |           |                  |CHECK IX) APPROPRIATE ITEM2.  INDICATE OTHER BUSINESS MACHINES WITH WHICH YOU HAVE HAD OPERATING EXPERIENCE OR TRAINING (Complometer,    Mirοugmph, Card Punch, Etc.).SECTION VIII SPECIAL QUALIFICATIONS1.  LIST ALL HOBBIES AND SPORTS IN WHICH YOU ARE ACTIVE OR HAVE ACTIVELY PARTICIPATED. INDICATE YOUR PROFICIENCY    IN EACH.2.  INDICATE ANY SPECIAL QUALIFICATIONS RESULTING FROM EXPERIENCE OR TRAINING WHICH MIGHT FIT YOU FOR A    PARTICULAR POSITION OR TYPE OF WORK.3.  EXCLUDING BUSINESS EQUIPMENT OR MACHINES WHICH YOU MAY HAVE LISTED IN ITEM 2. SECTION VII, LIST ANY SPECIAL    SKILLS YOU POSSESS RELATING TO OTHER EQUIPMENT AND MACHINES SUCH AS OPERATION OF SHORTWAVE RADIO (Indi    cate CW speed, sending and receiving), OFFSET PRESS, TURRET LATHE, SCIENTIFIC AND PROFESSIONAL DEVICES.SECTION VIII CONTINUED TO PAGE
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SECTION VIII CONTINUED FROM PAGE 14. ARE YOU NOW OR HAVE YOU EVER BEEN A LICENSED OR CERTIFIED MEMBER OF ANY TRADE OR PROFESSION, SUCH AS PILOT, ELECTRICIAN, RADIO OPERATOR, TEACHER, LAWYER, CPA, MEDICAL TECHNICIAN, ETC.?[] YES  [] NO5. IF YOU HAVE ANSWERED "YES" TO ABOVE, INDICATE KIND OF LICENSE AND STATE ISSUING LICENSE (Provide License Registry Number, if known).6. FIRST LICENSE OR CERTIFICATE (Year of Issue)7. LATEST LICENSE OR CERTIFICATE (Year of Issue)8. LIST ANY SIGNIFICANT PUBLISHED MATERIALS OF WHICH YOU ARE THE AUTHOR (Do NOT submit copies unless requested). INDICATE THE TITLE, PUBLICATION DATE, AND TYPE OF WRITING (Non-Fiction or Scientific articles, General Interest subjects, Novels, Short Stories, etc.).9. INDICATE ANY DEVICES WHICH YOU HAVE INVENTED AND STATE WHETHER OR NOT THEY ARE PATENTED.10. LIST PUBLIC SPEAKING AND PUBLIC RELATIONS EXPERIENCE.Public Speaking - GSIA - Pitt University 1953-5511. LIST ANY PROFESSIONAL, ACADEMIC OR HONORARY ASSOCIATIONS OR SOCIETIES IN WHICH YOU ARE NOW OR WERE FORMERLY A MEMBER. LIST ACADEMIC HONORS YOU HAVE RECEIVED.SECTION IX EMPLOYMENT HISTORYNOTE: (LIST LAST POSITION FIRST.) Indicate chronological history of employment for past 15 years. Account for all periods including casual employment and all periods of unemployment. Give address and state what you did during periods of unemployment. List all civilian employment by a foreign Government, regardless of dates. In completing item 9, "Description of Duties" consider your experience carefully and provide meaningful, objective statements.1. INCLUSIVE DATES (From and To - By Mo. and Yr.)5/1/58 - 3/1/612. NAME OF EMPLOYING FIRM OR AGENCY.3. ADDRESS (No., Street, City, State, Country)4. KIND OF BUSINESS5. NAME OF SUPERVISOR6. TITLE OF JOB7. SALARY OR EARNINGSPER8. CLASS. GRADE (II Federal Service)9. DESCRIPTION OF DUTIES10. REASONS FOR LEAVINGPrimarySECTION IX CONTINUED TO PAGE
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SECTION IX CONTINUED FROM PAGE 61. INCLUSIVE DATES (From and To - By Mo. and Yr.)2. NAME OF EMPLOYING FIRM OR AGENCY3. ADDRESS (No., Street, City, State, Country)4. KIND OF BUSINESS5. NAME OF SUPERVISOR6. TITLE OF JOB7. SALARY ON EARNINGS8. CLASS. GRADE (If Federal Service)   PER9. DESCRIPTION OF DUTIES10. REASONS FOR LEAVING1. INCLUSIVE DATES (From and To - By Mo. and Yr.)2. NAME OF EMPLOYING FIRM OR AGENCY3. ADDRESS (No., Street, City, State, Country)4. KIND OF BUSINESS5. NAME OF SUPERVISOR6. TITLE OF JOB7. SALARY ON EARNINGS8. CLASS. GRADE (If Federal Service)   PER9. DESCRIPTION OF DUTIES10. REASONS FOR LEAVING1. INCLUSIVE DATES (From and To - By Mo. and Yr.)2. NAME OF EMPLOYING FIRM OR AGENCY3. ADDRESS (No., Street, City, State, Country)4. KIND OF BUSINESS5. NAME OF SUPERVISOR6. TITLE OF JOB7. SALARY ON EARNINGS8. CLASS. GRADE (If Federal Service)   PER9. DESCRIPTION OF DUTIES10. REASONS FOR LEAVING1. INCLUSIVE DATES (From and To - By Mo. and Yr.)2. NAME OF EMPLOYING FIRM OR AGENCY3. ADDRESS (No., Street, City, State, Country)4. KIND OF BUSINESS5. NAME OF SUPERVISOR6. TITLE OF JOB7. SALARY ON EARNINGS8. CLASS. GRADE (If Federal Service)   PERSECTION IX CONTINUED TO PAGE 7
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SECTION IN CONTINGED FROM PAGE 69. DESCRIPTION OF DUTIES510. REASONS FOR LEAVING1. INCLUSIVE DATES(From and To - By Mo. and Yr.)2. NAME OF EMPLOYING FIRM OR AGENCY3. ADDRESS (No., Street, City, State, Country)4. KIND OF BUSINESS5. NAME OF SUPERVISOR6. TITLE OF JOB7. SALARY OR EARNINGS8. CLASS. GRADE (II Federal Service)PER9. DESCRIPTION OF DUTIES10. REASONS FOR LEAVING1. INCLUSIVE DATES(From and To - By Mo. and Yr.)2. NAME OF EMPLOYING FIRM OR AGENCY3. ADDRESS (No., Street, City, State, Country)4. KIND OF BUSINESS5. NAME OF SUPERVISOR6. TITLE OF JOB7. SALARY OR EARNINGS8. CLASS. GRADE (II Federal Servico)PER8. IF PRIOR SERVICE WITH THE FEDERAL GOVERNMENT IS NOTED ABOVE, INDICATE THE   NUMBER OF YEARS CREDITABLE TOWARD U.S. CIVIL SERVICE RETIREMENT, IF KNOWN.2.  14-3.9. HAVE YOU EVER BEEN DISCHARGED OR ASKED TO RESIGN FROM ANY POSITION.  ☐ YES ☐ NOHAVE YOU LEFT A POSITION UNDER CIRCUMSTANCES WHICH YOU DESIRE TO EXPLAIN? ☐ YES ☒ NOIF YOUR ANSWER TO EITHER OR BOTH QUESTIONS IS "YES", GIVE DETAILS- 7 -
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# SECTION XI FINANCIAL STATUS1. ARE YOU ENTIRELY DEPENDENT ON YOUR SALARY2. IF YOUR ANSWER IS "NO" TO THE ABOVE, STATE SOURCES OF OTHER INCOME3. BANKING INSTITUTIONS WITH WHICH YOU HAVE ACCOUNTSNAME OF INSTITUTIONADDRESS (City, State, Country)4. HAVE YOU EVER BEEN IN, OR PETITIONED FOR, BANKRUPTCYYES NO5. IF YOUR ANSWER IS "YES" TO THE ABOVE, GIVE PARTICULARS, INCLUDING COURT AND DATE(S)6. GIVE THREE CREDIT REFERENCES IN THE UNITED STATESNAMEADDRESS (No., Street, City, State)7. DO YOU RECEIVE AN ANNUITY FROM THE UNITED STATES OR DISTRICT OF COLUMBIA GOVERNMENT UNDER ANY RETIREMENT ACT, PENSION, OR COMPENSATION FOR MILITARY OR NAVAL SERVICE?YES NO8. IF YOUR ANSWER IS "YES" TO THE ABOVE QUESTION, GIVE COMPLETE DETAILS9. DO YOU HAVE ANY FINANCIAL INTEREST IN, OR OFFICIAL CONNECTIONS WITH NON-U.S. CORPORATIONS OR BUSINESSES; OR IN OR WITH U.S. CORPORATIONS ON BUSINESSES HAVING SUBSTANTIAL FOREIGN INTERESTS?YES NO(If answer "YES", furnish details on separate sheet.)# SECTION XII MARITAL STATUS1. PRESENT STATUS (Single, Married, Widowed, Separated, Divorced, or Annulled) SPECIFY:2. STATE DATE, PLACE, AND REASON FOR ALL SEPARATIONS, DIVORCES OR ANNULMENTSWIFE, HUSBAND OR FIANCE: If you have been married more than once - including annulments - use a separate sheet for former wife or husband giving data required below for all previous marriages. If marriage contemplated, fill in appropriate information for fiance.(Middle) (Maiden) (Last)Lynch3. DATE OF MARRIAGE4. PLACE OF MARRIAGE (City, State, Country)5. HIS (OR HER) ADDRESS BEFORE MARRIAGE (No., Street, City, State, Country)6. LIVING?YES NO7. CURRENT ADDRESS (Give last address, if deceased)8. DATE OF BIRTH9. CAUSE OF DEATH10. PLACE OF BIRTH (City, State, Country)11. CITIZENSHIPSECTION XII CONTINUED TO PAGE 10- 9 -
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# 10SECTION XII CONTINUED FROM PAGE 914. IF BORN OUTSIDE U.S. DATE OF ENTRY15. PLACE OF ENTRY16. FORMER CITIZENSHIP(S)17. DATE U.S. CITIZENSHIP 18. WHERE ACQUIRED (City, State, Country)    ACQUIRED19. OCCUPATION20. PRESENT EMPLOYER (Also give former employer, or if spouse deceased or unemployed give last two employers)21. EMPLOYER'S OR BUSINESS ADDRESS (No., Street, City, State, Country)22. DATES OF MILITARY SERVICE (From-and-To (Mo., and Yr.)23. BRANCH OF SERVICE24. COUNTRY WITH WHICH MILITARY SERVICE AFFILIATED25. DETAILS OF OTHER GOVERNMENT SERVICE. U.S. OR FOREIGNSECTION XIII## CHILDREN AND OTHER DEPENDENTS1. PROVIDE THE FOLLOWING INFORMATION FOR ALL CHILDREN AND DEPENDENTS| NAME | RELATIONSHIP | DATE AND PLACE OF BIRTH | CITIZENSHIP | ADDRESS || ---- | ------------ | ----------------------- | ----------- | ------- ||      |              |                         |             |         ||      |              |                         |             |         ||      |              |                         |             |         ||      |              |                         |             |         |2. NUMBER OF CHILDREN (Including step-children and adopted children) WHO ARE UNMARRIED, UNDER 21 YRS. OF AGE, AND NOT SELF-SUPPORTING.3. NUMBER OF OTHER DEPENDENTS (Including spouse, parents, step-parents, sister, etc.) WHO DEPEND ON YOU FOR AT LEAST 50% OF THEIR SUPPORT, OR CHILDREN OVER 21 YRS. OF AGE WHO ARE NOT SELF-SUPPORTING.SECTION XIV## FATHER (Give same information, for Stepfather and/or Guardian on a separate sheet)1. FULL NAME (Last-First-Middle)2. LIVING3. DATE OF DEATH4. CAUSE OF DEATH5. CURRENT ADDRESS: Give last address, if deceased (No., Street, City, State, Country)6. DATE OF BIRTH7. PLACE OF BIRTH (City, State, Country)8. CITIZENSHIP9. IF BORN OUTSIDE U.S. DATE OF ENTRY10. PLACE OF ENTRY11. FORMER CITIZENSHIP(S) (Country(ies))12. DATE U.S. CITIZENSHIP ACQUIRED13. WHERE ACQUIRED (City, State, Country)14. OCCUPATION15. PRESENT EMPLOYER (Give last employer, if Father is deceased or unemployed)16. EMPLOYER'S BUSINESS ADDRESS OR FATHER'S BUSINESS ADDRESS IF SELF-EMPLOYED.17. DATES OF MILITARY SERVICE (From-and-To)18. BRANCH OF SERVICE19. COUNTRY20. DETAILS OF OTHER GOVERNMENT SERVICE. U.S. OR FOREIGN
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# SECTION XXVI16. ## CERTIFICATIONI HAVE INF(OR)MED THAT THE CORRECTNESS OF ANY STATEMENT MADE IN THIS APPLICATION WILL BE INVESTIGATED.I have read and understand the instructions. I Certify that the foregoing answers are true and correct to the best of my knowledge and belief. I agree that any misstatement or omission as to material fact will constitute grounds for immediate dismissal or rejection of my application. I also understand that any false statement made herein may be punishable by law (U.S. Code, Title 18, Section 1001).1. DATE OF SIGNATURES2. SIGNATURE OF APPLICANT3. SIGNED AT (City and State)4. SIGNATURE OF WITNESSNOTE: Use the following space for extra details. Reference each continued item by section and item number to which it relates, sign your name at the end of the added material. If additional space is required use extra pages the same size as this page and sign each such page.![signature]